Interactive figures

for 'TSH and FT4 reference interval recommendations: optimization of current methods'

Interactive heatmaps depict the F-scores (diagnostic performance measure of sensitivity and positive predictive value) for various modifications of the non-pregnancy TSH upper limit and the non-pregnancy FT4 lower limit.

Hoovering over the figures reveals other diagnostic performance measures for that particular combination of TSH and FT4 reference limit modification.

Performance measures used:

Sensitivity (true positive rate, true positives among all with a positive test result)

PPV=Positive Predictive Value (true positives among all with a positive test result)

CI= Confidence interval

PI=Prediction interval

I2= I2 statistic (proportion of total variability in effect sizes due to true heterogeneity rather than

sampling error)

Methods used to simulate the current standard 'trimester specific reference intervals':

1) Relative subtraction from upper limit of TSH varying from -5% to -50% in steps of 5% with subtraction or additions to the lower limit of FT4 varying from -20% to +20% in steps of 5% (relative subtraction approach),

2) Subtraction from the upper limit of TSH varying from -0.1 to -1.0 mU/L with subtraction or additions to the lower limit of FT4 varying from -5 to +5 pmol/L (-0.39 to +0.39 ng/dL; absolute subtraction approach) and

3) Using nonpregnancy reference limits with a fixed upper limit for TSH, varying from 3.0 to 4.5 mU/L, and a fixed lower limit for FT4, varying from 5 to 15 pmol/L (0.39-1.17 ng/dL; fixed limit approach).

Please see the original manuscript for a detailed description of the methodology (link will be added after publication).